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MIGS werden in der Regel bei fr\u00fchen bis intermedi\u00e4ren Glaukomen eingesetzt. In dieser retrospektiven Studie analysierten wir allerdings die Reduktion von Intraokulardruck (IOD) und topischer Glaukommedikation (Meds) durch die Kahook-Trabekulotomie (TO) ohne (<jats:italic>n<\/jats:italic>\u202f=\u200919) oder mit (<jats:italic>n<\/jats:italic>\u202f=\u200918) kombinierter Kataraktoperation (Cat-TO) als Initialintervention vor bzw. zur Vermeidung der filtrierenden Glaukomchirurgie.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material und Methoden<\/jats:title>\n                <jats:p>Es wurden 37\u00a0Augen von 37\u00a0Patienten untersucht, bei denen an mindestens 2 Untersuchungen trotz maximal tolerierbarer Meds IOD-Werte &gt;\u202f21\u202fmm\u202fHg gemessen wurden. Die Cat-TO wurde in 18\u00a0phaken Augen (prim\u00e4res Offenwinkelglaukom [POWG]\u202f=\u200911, Pseudoexfoliationsglaukom [PEX]\u202f=\u20095, okul\u00e4re Hypertension [OHT]\u202f=\u20092) durchgef\u00fchrt. In 19\u00a0pseudophaken Augen (POWG\u202f=\u200912, PEX\u202f=\u20096, OHT\u202f=\u20091) wurde eine isolierte TO durchgef\u00fchrt. Der absolute Erfolg (keine Meds) und der relative Erfolg (unabh\u00e4ngig von Meds) f\u00fcr IOD \u2264\u202f21\u202fmm\u202fHg, \u2264\u202f18\u202fmm\u202fHg, \u2264\u202f16\u202fmm\u202fHg wurden nach\u00a02, 6 und 12\u00a0Monaten postoperativ evaluiert.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Der IOD wurde signifikant von pr\u00e4operativ zu 2\u00a0Monate nach Cat-TO als auch nach TO gesenkt (Cat-TO: 26,8\u202f\u00b1\u20095,9\u202fmm\u202fHg auf 16,0\u202f\u00b1\u20092,9\u202fmm\u202fHg, <jats:italic>p<\/jats:italic>\u202f&lt;\u20090,001; TO: IOD 28,2\u202f\u00b1\u20095,6\u202fmm\u202fHg auf 16,3\u202f\u00b1\u20093,5\u202fmm\u202fHg, <jats:italic>p<\/jats:italic>\u202f&lt;\u20090,001). Die Meds-Reduktion war nach Cat-TO als auch nach TO nicht signifikant (Cat-TO: 2,1\u202f\u00b1\u20091,3 auf 1,3\u202f\u00b1\u20091,3, <jats:italic>p<\/jats:italic>\u202f=\u20090,11; TO: Meds 2,7\u202f\u00b1\u20091,1 auf 2,2\u202f\u00b1\u20091,3, <jats:italic>p<\/jats:italic>\u202f=\u20090,23). Jedoch war die Meds-Reduktion nach\u00a06 und 12\u00a0Monaten signifikant gr\u00f6\u00dfer in der Cat-TO-Gruppe verglichen mit der TO-Gruppe (<jats:italic>p<\/jats:italic>\u202f=\u20090,02). IOD und Meds \u00e4nderten sich nicht signifikant von der 2\u2011Monats- zur 6\u2011 und 12-Monats-Visite. Nach Cat-TO war der relative Erfolg nach 12\u00a0Monaten f\u00fcr IOD \u2264\u202f18\u202fmm\u202fHg 61\u202f% (11\/18) und f\u00fcr IOD \u2264\u202f16\u202fmm\u202fHg 28\u202f% (5\/18). Der relative Erfolg nach 12\u00a0Monaten f\u00fcr die TO lag bei 47\u202f% (9\/19) f\u00fcr IOD \u226418\u202fmm\u202fHg und 26\u202f% (5\/19) f\u00fcr IOD \u2264\u202f16\u202fmm\u202fHg. Bei 7\u00a0Patienten in der TO und 2\u00a0Patienten in der Cat-TO-Gruppe war die Intervention nicht ausreichend (IOD zweimalig &gt;\u202f21\u202fmm\u202fHg).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Schlussfolgerungen<\/jats:title>\n                <jats:p>Die 12-Monats-Daten zeigen, dass die TO also auch die Cat-TO ([Cat-]TO) ein wirksamer minimal-invasiver Eingriff ist, um eine Trabekulektomie hinauszuz\u00f6gern oder sogar zu verhindern. Bei Tropfunvertr\u00e4glichkeiten und Zieldruckwerten \u2264\u202f16\u202fmm\u202fHg ist die (Cat\u2011)TO nicht ausreichend.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00347-023-01835-3","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:45:12Z","timestamp":1679881512000},"page":"825-831","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ab-interno-Trabekulotomie ohne\/mit Kataraktoperation\u00a0\u2013 Eine Therapiealternative vor bzw. anstatt Trabekulektomie bei Patienten mit hohen Augeninnendr\u00fccken?","Ab interno trabeculotomy without\/with cataract operation\u2014An alternative treatment before or instead of trabeculectomy in patients with high intraocular pressure?"],"prefix":"10.1007","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-4050","authenticated-orcid":false,"given":"Sabine","family":"Baumgarten","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tibor","family":"Lohmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Prinz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Walter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niklas","family":"Plange","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Fuest","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,3,19]]},"reference":[{"issue":"6","key":"1835_CR1","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1007\/s00347-018-0844-4","volume":"116","author":"C van Oterendorp","year":"2019","unstructured":"van Oterendorp\u00a0C, Bahlmann\u00a0D (2019) Kahook dual blade : an instrument for microincisional trabecular meshwork surgery. 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